Antibiotics overuse drives fatal attraction

A dangerous overuse of antibiotics and antivirals is driving an alarming decline in human resistance to superbugs and other infections.

One of Australia’s leading anti­microbial experts warns that increased resistance to prescription medicines stands to undermine Australia’s healthcare systems.

Overuse of antibiotics and anti­virals is driving an alarming decline in human resistance to superbugs and other infections, say the country’s leading anti­microbial experts, who warn that increased resistance to prescription medicines stands to undermine Australia’s healthcare systems.

John Turnidge said Australia was caught in a “downward spiral of antibiotic resistance” that threatened to become a leading cause in deaths, despite a gradual decline in prescription medicines.

Professor Turnidge, an adviser to the commission on safety and quality in healthcare, told The Weekend Australian that GPs were trapped in a “vicious historical cycle” in which you were labelled a “bad doctor” if you denied patients antibiotic treatment.

“When penicillin first came out, it was branded very strongly by governments and the media as a miracle. And the average citizen came to expect that if I’ve got an infection, I need a miracle. And so this high level of usage became almost part of the culture,” he said.

“At the sharp end of this crisis, the more antibiotics are used, the more resistance is generated and the more likely you are to land in hospital with an infection, which puts you at risk of dying because the antibiotics are no longer working in they way they should.

“There’s also the fact that if there is more resistance to bugs around all medical practices that we undertake – in surgery, in medicine, in obstetrics, in neonatal – then we’ll have more problems with antibiotics and get caught having to use last-resort antibiotics and it will turn into a complete downward spiral.”

This comes as the Australian Medical Association warned against the rapid increase in antimicrobial resistance and over­prescription in a newly released report, arguing that the country’s healthcare system was headed towards “the medical dark ages” unless government and industry combined to confront the crisis.

AMA president Steve Robson said the federal government needed to establish a centre for disease control to combat superbugs and counter the antimicrobial resistance crisis. “We are on track to return to a time where a superficial scratch could be life-threatening, and the procedures and treatments which we now rely on are considered too risky to perform, due to risk of untreatable infection,” he said.

“Antimicrobial resistance is one of the most serious global health threats of the 21st century, documented in almost all regions of the world. Many consider it to be a silent global pandemic that will undermine healthcare systems and food safety and supply, and result in millions of deaths.”

In NSW, pharmacists will be able to prescribe medications, including the contraceptive pill and antibiotics, under reforms to ease pressure on NSW’s health system.

The 12-month trial will mirror a similar pilot program in regional Queensland, allowing pharmacists to prescribe medication such as antibiotics to treat uncomplicated urinary tract infections.

Sydney-based GP Danielle McMullen said the state experiments presented a significant risk to antimicrobial resistance, with pharmacists lacking the experience and facilities to properly diagnose patients. “GPs have access to diagnostics which can tell if a patient actually has a bacterial infection in the first place, and whether it is resistant to certain antibiotics, to ensure patients receive the right care at the right time,” Dr McMullen said.

“Australia is already lagging when it comes to antimicrobial stewardship, and these trials are a step in the wrong direction.”

Professor Turnidge said the trials would actively work against “everything we’re trying to achieve” in combating antimicrobial resistance. “Pharmacies were advised ‘Please, do not do this’, and they did it anyway. It’s a reflection of the power of the pharmacy lobby. That [antibiotic] usage will not be documented and we won‘t be able to measure it, which is a perfect nightmare.”